Alcohol and your liver: how alcohol-related liver disease develops
Risky SubstancesKey points
- Stages: fatty liver → hepatitis → cirrhosis.
- Prevalence of and deaths from alcohol-related liver disease are rising in the U.S.
- Alcohol is a major cause of liver cancer.
- In early stages, quitting alcohol lets the liver recover.
What the research shows
An analysis of three large U.S. databases found that the prevalence of alcohol-related liver disease and deaths from it increased over the past two decades, with especially sharp rises among younger adults and women (Dang et al., 2020). Alcohol-related deaths rose further during the COVID-19 pandemic.
Alcohol is also a cause of liver cancer: a global analysis estimated that 741,000 new cancer cases in 2020 were attributable to alcohol, including liver cancer (Rumgay et al., 2021).
Stages
- Fatty liver: fat builds up in liver cells; usually no symptoms and reversible.
- Alcoholic hepatitis: inflammation that can be mild or life-threatening.
- Cirrhosis: permanent scarring that impairs liver function.
What helps your liver
- Drink less, or not at all; the GBD analysis found the healthiest level is zero (GBD 2016 Alcohol Collaborators, 2018).
- Maintain a healthy weight; obesity also causes fatty liver.
- Get vaccinated against hepatitis A and B.
- Avoid unnecessary supplements and use acetaminophen only as directed.
Frequently asked questions
How much drinking damages the liver?
Risk rises with the amount and duration. Heavy drinking for years, roughly more than 3 to 4 drinks a day for women and 4 to 5 for men, carries high risk, but there is no completely safe level.
Can the liver heal?
Fatty liver can reverse within weeks to months of not drinking. Cirrhosis is scarring that does not fully reverse, but stopping drinking still improves survival.
Sources
- Dang et al. (2020). Alcoholic Liver Disease Epidemiology in the United States: A Retrospective Analysis of 3 US Databases. American Journal of Gastroenterology 115(1):96-104. doi:10.14309/ajg.0000000000000380
- Rumgay et al. (2021). Global burden of cancer in 2020 attributable to alcohol consumption: a population-based study. The Lancet Oncology 22(8):1071-1080. doi:10.1016/S1470-2045(21)00279-5
- Griswold et al. (2018). Alcohol use and burden for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet 392(10152):1015-1035. doi:10.1016/S0140-6736(18)31310-2
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